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3. Sys Path > C16 pt 2 > Flashcards

C16 pt 2 Flashcards

1
Q

Intestinal encephalopathy
- sometimes seen in a horse with what condition?
- similar to what?

A

o Sometimes seen in horses with colitis (excess production of ammonia in the colon?)
o Similar to hepatic encephalopathy

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2
Q

Rectal prolapse
- associated with?
- possible sequelae?
- species specific causes for pig, dog, sheep

A

o Any species, often associated with straining or increased abdominal pressure (ex.
urinary obstruction, coughing)
o Prolapsed segment becomes edematous and ischemic, may slough
o Sloughing may result in stricture
<><>
- Pig: Zearalenone toxicity from Fusarium spp. mold
- Dog: Brachycephalics predisposed
- sheep: Excessively short docking predisposes

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3
Q

Jejunal hematoma (AKA hemorrhagic bowel syndrome) in cows
- signalment?
- outcome?
- appearance?

A

o Adult dairy cows, usually causes sudden death but cause is unknown
o Loops of jejunum obstructed by mural hemorrhage, often sharply demarcated
o Affected segments often have mucosal tears that allow blood into the lumen

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4
Q

Duodenitis-proximal jejunitis (AKA proximal enteritis) in the horse
- what is it?
- may lead to?
- what does it cause?

A

o Upper SI ileus of unknown cause
o Fibrinous enteritis or ulceration of the duodenum, variable extent but spares ileum
o May lead to stricture in chronic cases and may cause peritonitis
o Causes depression, nasogastric reflux, gastric distention and ulceration, occasionally
gastric rupture

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5
Q

Diagnosing GI disease
* Generating a suitable list of differential diagnoses requires you to know:

A

species and age

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6
Q

Mixed infections are common and often different agents produce the same clinical
disease = ______ diarrhea (until a cause is identified)

A

undifferentiated

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7
Q

Diagnosing GI disease
* Many agents are transient or cause lesions that are easily obscured by autolysis
- what is it important to examine to make this less of an issue?

A

o Examining live, untreated animals early in the course of disease is important!

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8
Q

A modified postmortem approach is used in enteric disease to ensure….

A

…to ensure sections of the gut are fixed in formalin ASAP
o Normally we work from ‘clean to dirty’; in these cases we go straight to the gut

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9
Q

good type of scraping for diagnosing GI diseases

A
  • Some diseases (ex. cryptosporidiosis, coccidia) can be diagnosed from mucosal scrapings
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10
Q

peritoneum
- surface area
- lined by?
- damage and healing?
- how does it heal?
- what growth abnormalities are common?

A
  • Larger surface area than skin, lined by mesothelium
    o Easily damaged but heals rapidly via free-floating progenitors
    o Healing is even through defect (not edges in)
    o Hyperplasia/metaplasia common, can look neoplastic
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11
Q

Peritoneum and retroperitoneum
- involved in what functions?
- what is the retroperitoneum?
- disease in peritoneal cavity usually secondary to what?
- general fluid amount? ante vs post mortem?

A
  • Involved in lubrication, immune surveillance, regulation of inflammation and healing
    <><><><>
  • Retroperitoneum refers to all structures between the peritoneum and dorsal muscles
    o Blood vessels, nerves, connective tissue, adipose (good place to see serous atrophy)
    <><><><>
  • Disease is usually secondary to problems with the organs in the peritoneal cavity
    <><><><>
  • Usually little fluid, must differentiate antemortem effusions from postmortem
    accumulation (red-tinged, does not clot)
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12
Q

Ascites
- what type of fluid?
- 2 mechanism of development
- what can make it worse?

A
  • Excess fluid, usually modified transudate (watery, clear, straw coloured)
    o Two mechanisms of development…
    <><><><>
  • Excess production
    o Increased hydrostatic pressures in hepatic and portal circulation
    o Most commonly due to fibrosis and congestive heart failure
    o Or, leakage of chylous fluid from cisterna chyli
    <><>
  • Insufficient removal
    o Obstructed lymphatic drainage to thorax
    o Ex. carcinomatosis, space-occupying lesion in thorax
    <><><><>
  • Sodium retention and hypoproteinemia due to liver disease can make ascites worse
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13
Q

Congenital pleuroperitoneal diaphragmatic hernia
- most common in what species?
- issues?

A

o Most common in dogs
o Herniation of organs into chest can cause respiratory distress, incarceration

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14
Q

Peritoneopericardial diaphragmatic hernia
- usually in what animals?
- how does it happen?
- possible outcomes?

A

o More common form, usually seen in small animals and may have other defects
o Diaphragm does not fuse or fails to develop properly
o Clinically silent or organ herniation causes cardiac tamponade

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15
Q

Possible consequences of blunt trauma:

A

Contusions
- Often skin or subcutaneous lesions line up with organ contusions
<><>
Mesenteric/vascular avulsion
- Causes hemorrhage, infarction
<><>
Capsular fracture of solid organs
- Causes hemorrhage, pallor, splenic contraction, splenosis if spleen damaged
<><>
Hollow organ rupture (bladder, gut, uterus, etc)
- Releases contents, can cause peritonitis; in pregnant females, released fetuses will die and cause peritonitis if not removed
<><>
Acquired hernia
- Often diaphragmatic as the diaphragm is weaker than the abdominal wall

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16
Q

why are bladder ruptures hard to find?
- uroperitoneum looks like what? how to differentiate?

A
  • Bladder ruptures are hard to find, as the bladder contracts as urine leaks
    o Uroperitoneum looks like ascites – compare creatinine level to serum to confirm
17
Q

Acquired diaphragmatic hernias
- must confirm what?
- in SA, usually what structure?
- progression and signs?
- in horses, usually what structure and signs?

A

o Must confirm the hernia developed antemortem (fibrin, hemorrhage, etc)
o In small animals, usually muscular diaphragm
o May be subclinical at first but progresses to respiratory distress, tympany, obstruction,
or abnormal fluid accumulation in the thorax +/- abdomen
o In horses, usually tendinous diaphragm, causes colic rather than respiratory distress

18
Q

Uroperitoneum
- causes? in neonates?

A

o Usually due to urolithiasis, in neonates caused by bladder rupture (especially foals)

19
Q

Digesta in abdomen
- cause? species most commonly affected?
- location
- why can it be hard to find?
- Rectal perforation in horses: cause?
- MUST CONFIRM WHAT? how?

A

o GI rupture or perforation, most common in horses and cattle
o Can occur anywhere due to foreign bodies, impaction, devitalization
o Site of leakage may be hard to find if there is peritonitis
o Rectal perforation in horses: often iatrogenic, sometimes during parturition
o MUST CONFIRM IF ANTEMORTEM! (hemorrhage, exudate, inflammation)

20
Q

Pneumoperitoneum
- cause

A

o Perforated body wall or intestine
most common

21
Q

Hemoperitoneum
- character?
- spontaneous reasons?

A

o May be fluid or partly clotted,
traumatic or spontaneous
o Spontaneous: splenic torsion +/-
rupture, GDV, coagulopathy, tumours, ruptured uterus or uterine artery in mares

22
Q

Abdominal fat necrosis
- associated with what condition in SA?
- appearance?

A
  • In small animals, associated with pancreatitis
    o White spots with red borders
23
Q

Massive abdominal fat necrosis
- signalment
- what happens
- possible issues?

A

o Poorly understood condition of older, fat, channel island cows
(Jersey, Guernsey)
o Multifocal to coalescing masses of necrotic fat (firm, dry, chalky)
o Often incidental but can cause fatal compression or obstruction of other organs

24
Q

Steatitis
- what is it?
- related to?

A

o Peroxidation of adipose throughout the body causes painful inflammation
o Related to high PUFA, low tocopherol diets (vitamin E deficiency in rancid fatty diets)

25
Q

Peritonitis
- species?
- character?

A
  • Common in large animals, rare in companion animals
    o Variety of types of exudate based on cause
    o Most cases are secondary but some agents cause primary infectious peritonitis
    o May be acute or chronic, local or diffuse, septic or not
26
Q

Chemical peritonitis
- can be caused by?

A

o Surgical glove powder (granulomatous), bile, pancreatic enzymes (localized)

27
Q

Bacterial peritonitis
- causes?

A

o Direct penetration, GI rupture/devitalization, extension from female reproductive tract
o May also extend from an inflammatory nidus (ex. umbilical abscess)

28
Q

peritonitis in the horse
- features
- healing
- cause
- type

A
  • Usually diffuse, acute, fatal
  • Small omentum and poor healing capacity
  • GI rupture most common cause
  • Localized possible with castration, mesenteric Streptococcus abscesses
29
Q

peritonitis in cattle
- features
- immune system
- causes
- sequelae
- neonates causes

A
  • Acute, diffuse, fibrinopurulent progressing to chronic, fibrotic
  • Excellent at walling off inflammation and forming abscesses
  • Usually due to GI or reproductive tract perforation
  • Chronic disease can lead to vagus indigestion
  • Hardware disease may involve the pericardium
  • In neonates, may extend from umbilical infection
30
Q

peritonitis in small ruminants
- cause?

A

Ruptured caseous lymphadenitis lesions or reproductive origin

31
Q

peritonitis in pigs?
- features
- causes

A
  • Serofibrinous
  • Commonly due to Glasser’s disease (polyserositis), also septicemic bacteria (Streptococcus suis, Mycoplasma spp., Trueperella pyogenes)
32
Q

periotnitis in dogs cause

A

Usually hollow organ contamination or bacteremia, bacteria vary

33
Q

peritonitis in cats?
- features
- cause

A
  • Mostly fibrinopurulent
  • FIP pyogranulomatous
  • Ruptured pyometra, penetrating wounds, Actinomyces spp.
34
Q

Peritonitis - consequences

A
  • Ileus: supports development of adhesions
  • Electrolyte and fluid sequestration in peritoneum and gut
  • Absorption of bacterial toxins into lymphatics (may be fatal before gross lesions develop)
    <><>
  • Possible outcomes of peritonitis
    1) Resolution
    2) Persistence in localized regions (abscesses) 3) Fibrosis
    <><>
  • Fibrin that is not removed by 3-4 days becomes organized into fibrosis
    o Effect of adhesions depends on location (subclinical, obstruction, or stenosis) o Ischemia, foreign material, necrosis, and sepsis all promote fibrosis
35
Q

Mesothelioma
- common?
- malignant?
- species?
- hard to tell from what?
- spread?
- effects?
- appearance?

A

Mesothelioma: rare, always malignant, most common in cattle and dogs
o Hard to tell apart from reactive mesothelium
o Spread by implantation (not necessarily metastasis), often blocks lymphatics (ascites) o Can affect peritoneum, pleura, and pericardium simultaneously
o Variable gross appearance, can resemble peritonitis or carcinoma

36
Q

Lipomas (peritoneal)
- common?
- age/species?
- when problematic
- metastatic?
- appearance?

A
  • Lipomas: most common peritoneal interstitial tumour, especially old horses
    o Problem if mesenteric lipomas become pedunculated (why?)
    o Always benign, often have a friable necrotic core
37
Q

what cancers can implant on peritoneum?
- primary tumour locations?

A
  • Carcinomas and less commonly sarcomas can implant on peritoneum
    o Look for the primary tumour
    o Ovarian, biliary, pancreatic, intestinal,
    prostatic, renal carcinomas
    o Gastric squamous cell carcinoma,
    transitional cell carcinoma
    o Melanoma in grey horses and occasionally
    dogs, etc etc
38
Q

parasites in the peritoneum
- why?
- which ones?

A
  • Parasites are mostly accidental or on their way somewhere else
    o Migrating flukes can cause peritonitis in ruminants
    o Setaria spp. nematodes are incidental inhabitants of the ruminant peritoneum
    o Larval cestodes and errant Dioctophyme renale are usually incidental

3. Sys Path (28 decks)

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